The relationship between disability and suicide in Australian men

A new study on on the relationship between disability and suicide ideation in men aged 18 to 55 was published earlier this month.

People with disability experience many forms of disadvantage and adversity, such as under- or unemployment, poverty, poor quality housing, low levels of education, and exposure to violence. Evidence also shows that people with disability have higher prevalence of poor mental health than their non-disabled counterparts. Several studies have found that prevalence of attempted suicide and thoughts of suicide is higher among people with disability, relative to people without disability. However, this research has mostly focused on specific subgroups of people with disability, such as people with multiple sclerosis, physical disability or intellectual disability.

Our research, published in the Journal of Public Health, used a broad measure of disability based on difficulty functioning in domains related to social participation (rather than specific conditions or impairments), to examine the association between disability and thoughts of suicide in Australian men aged 18 to 55 years.

Our results showed that:

  • Like in previous research, men with disability were more disadvantaged than non-disabled men and had poorer mental health.

Prevalence of thoughts of suicide in the past year for men with disability was nearly 10 percent, compared to 4 percent among men without disability.

  • After accounting for underlying mental health scores and other confounding factors, men with disability had about 50 percent greater odds of suicide ideation in the past 12 months than non-disabled men.
  • Having a disability was associated with about the same odds of suicide ideation as being unemployed, after taking underlying mental health into account.

One reason why men with disability may have increased odds of suicide ideation is that people with disability face considerable marginalisation in society, including segregation in schools and discrimination in employment settings. Disability may also bring about exposure to a range of behavioural risk factors for chronic disease, such as smoking and lack of physical activity, and chronic disease is a known risk factor for suicide.

Previous research also suggests that normative constructions of masculinity, which position men with disability as childlike and weak, may contribute to stereotypes and stigma toward men with disability. Future studies could examine possible relationships between masculine norms, disability, and suicide.

Based on findings from this analysis, there is a need for greater consideration of how the experience of disability might influence thoughts of suicide. People with disability make up a large minority of the population, and although members of this group are incredibly diverse, they are connected by common experiences of marginalisation and social exclusion. Further research is needed to examine the potential role that stigma and discrimination, health concerns, loss of social support, and other factors might play in the risk of suicide ideation among people with disability.

About the study

We used data from the first two waves of Ten to Men, a national survey of male health. Participants were recruited at the household level and completed paper questionnaires. The response rate in Wave 1 was 35 percent.

The total sample size for this analysis was 7,858 men aged 18 to 55 years.

Exposure, outcome, and other variables:

  • We classified disability status based on participants’ responses at Wave 1 to the Washington Group Short Set (WG-SS) questionnaire, an internationally used disability measure. The WG-SS asks about difficulty functioning in six domains: seeing; hearing; remembering or concentrating; self-care; walking or climbing stairs; and communicating or being understood. Participants who have a lot of difficulty or cannot do at all in any domain are considered to have disability.
  • We identified men who had thoughts of suicide in the past 12 months using data from the second wave, matched to participant data from the first wave.
  • We accounted for the underlying mental health of participants, measured at Wave 1.
  • We adjusted for a range of variables that could confound the association between disability and thoughts of suicide.

This is a summary based on the original article:

Milner A, Bollier A, Emerson E & Kavanagh A. The relationship between disability and suicide: prospective evidence from the Ten to Men cohortJournal of Public Health,  fdy197.